Wendy Kaye Pourbastani, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN068727 Issued in AZ

Practice address

6950 E Williams Field Rd
Carl T. Hayden VA Medical Center, Southeast Clinic
Mesa, AZ 85212-6033

Phone

(602) 222-6568

Fax

(602) 222-6496

NPI assigned

Jun 17, 2006

Last updated

May 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1508801218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E HEARNE WAY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852346018",
            "telephone_number": "480-497-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 E WILLIAMS FIELD RD",
            "address_2": "CARL T. HAYDEN VA MEDICAL CENTER, SOUTHEAST CLINIC",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852126033",
            "telephone_number": "602-222-6568",
            "fax_number": "602-222-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURBASTANI",
        "first_name": "WENDY",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN068727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret M Potesta, CSFA
• Dusanka Potkonjak
• Jeffrey Ryan Potts, ND
• Emily Poulos, D.D.S.
• Deborah Poulsen-McRae, LAC
• Sam Pourian, DC
• Faith A Pourkaveh
• Anjeanette Pout
• Daren Todd Povar, DPT
• Powell Medical LLC

• Adult Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.